Chapter 17: Geriatric Emergencies

Knowledge and Attitude Objectives

1. Describe some of the physiological changes that occur with aging.

2. Explain how to ensure more effective communication with elderly patients who have hearing or sight impairment.

3. Describe why geriatric patients are at high risk for broken bones.

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Knowledge and Attitude Objectives

4. Explain the types of cardiovascular and respiratory diseases that are prevalent among elderly patients.

5. Describe how to approach the assessment and treatment of chronically ill patients.

6. Explain your responsibility in dealing with patients who show signs of depression or dementia.

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Knowledge and Attitude Objectives

7. Describe the purpose of hospice care.

8. Explain the purpose of advance directives and living wills.

9. Describe the signs and symptoms of elder abuse.

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Geriatric Patients

• Defined as a patient who is more than 65 years of age• Geriatric population is fastest growing segment of U.S.

population.

Hearing-Impaired or Deaf Patients

• An invisible disability • Communication

– Speak clearly and maintain eye contact. – Do not shout.– Offer paper and pencil or use sign language.

Visually Impaired or Blind Patients

• Look for signs during scene size-up. • Tell patient what is happening. • Provide psychological support. • Keep glasses with patient if possible.

Musculoskeletal and Mobility Issues

• Muscles and bones lose strength as people age. • Osteoporosis

– Common in postmenopausal women• Together with decreased balance, these conditions result

in more falls among older people.

Slowed Movements

• Movements may be slowed in older patients.

• Lend a helping hand. • Do not rush elderly

patients.

Fractures

• Fractures of the wrist, spine, and hip are common. • Geriatric patients may not realize the seriousness

of their injury. • Every elderly patient who complains of pain after a fall

must be x-rayed.

Cardiovascular Diseases

• Conditions that affect the heart and blood vessels – Heart attack, angina, congestive heart failure – Strokes and abdominal aortic aneurysms

• Geriatric patients may not have the classic signs and symptoms.

Respiratory Diseases

• Major types:– Chronic (COPD)– Acute (pneumonia)

• Care:– Carefully examine patient. – Secure an accurate medical history.

Cancer

• Patients call EMS when complications arise. • Provide support. • Transport to a medical facility for stabilization.

Medications

• Many older people take a large number of medications daily.

• Medications may interact or cause side effects.

• Determine what medications are being taken and transport them with patient.

Chronic-Care Patients

• More patients are treated at home.• Complex medical devices include:

– Ventilators– Oxygen-enrichment devices– Pacemakers and implanted defibrillators– Feeding tubes– Catheters

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Chronic-Care Patients

• Patients often take a wide variety of medications.• Remember the basics of care.• Assess problem/ask patient or caregiver about the

problem.

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Depression

• Most common psychiatric condition in older adults • More common in women than in men• Contributing factors:

– Living alone– Loss of loved ones– Loss of independence– Declining health

Suicide

• Older men have a high rate of suicide in the United States.

• If you suspect a patient is suicidal, arrange for transport.

• Be alert for your safety.

Dementia

• Progressive and usually irreversible decline inmental function

• Marked by impairment in memory • May result in decreases in reasoning, judgment,

comprehension, and ability to communicate• Senile dementia is abnormal decline.

Alzheimer’s Disease

• Most common form of dementia• A chronic degenerative disorder that attacks the brain • Results in impaired memory, behavior, and thinking• Patients may experience mood swings and paranoia.

Caring for Patients With Dementia

• Speak clearly and communicate what you are doing. • Rely on family members or caregivers to provide

medical history. • Use a kind and

caring approach.

Hospice Care

• A health care program that provides physical, spiritual, social, and economic care for patients who have terminal illnesses

• Provides pain relief and other supportive care• EMS is usually called when the patient experiences

unexpected problems.

Advance Directives

• Patients who have a terminal illness may have an advance directive.

• Also called living wills or do not resuscitate orders (DNRs)

• Know the regulations concerning these documents in your state.

Elder Abuse

• May be physical, sexual, or emotional abuse or neglect

• Signs and symptoms:– Bruises– Burns– Malnourished

appearance